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Taking Care of Your Diabetes

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Taking Care of Your Diabetes Taking Care of Your Diabetes www.PalomarHealth.org/Diabetes Table of Contents What is Diabetes? 1 Blood Sugar Testing 3 Diabetes Medicines 5 Waste Collection Information 14 Hypoglycemia 15 Hyperglycemia 17 Sick Day Guidelines 19 Diabetic Ketoacidosis (DKA) 20 Healthy Meal Planning 21 Foods with Carbohydrates 22 Combination Foods 24 Reading a Nutrition Label 25 Foot Care 26 Diabetes and Emotions 27 Palomar Health Services 30 Good Questions for Your Good Health 32 Introduction Thank you for choosing Palomar Health. We want to thank you for allowing us to care for you. Your safety, comfort and satisfaction with our services are very important to us. In this book you will find information on: ■ Types of diabetes ■ What to do when you are sick ■ Testing your blood sugar ■ Healthy food choices ■ Diabetes medications ■ Exercise ■ Hypoglycemia or low blood sugar ■ Community education programs ■ Hyperglycemia or high blood sugar and resources While you are in the hospital, please ask your doctor and nurses about your: ■ Diabetes ■ Medications ■ Follow-up doctor appointments ■ Diabetes education classes and a support group Please bring this book with you to your doctor visits and/or classes that you attend. If you happen to come back to Palomar Health, please have someone bring this book to the hospital so that we can continue to go over any information you may want or need during your stay. We wish you good health. Sincerely, Palomar Health & the Diabetes Services Department Our mission: To heal, comfort and promote health in the communities we serve. Our vision: Palomar Health will be the health system of choice for patients, physicians and employees, recognized nationally for the highest quality of clinical care and access to comprehensive services. What is Diabetes? Diabetes is a disease in which the body does not make enough insulin and/or the cells in the body have a hard time using the insulin your body makes. Without enough insulin, your cells cannot get the fuel it needs to use for energy. The two most common types of diabetes: Type 1 diabetes: When you have Type 1 diabetes, your body stops making insulin. If you have Type 1 diabetes, you must take insulin. Type 2 diabetes: When you have Type 2 diabetes, your body is not making enough insulin nor is it using insulin the right way. There is no cure for diabetes. Diabetes does not go away. It is important to talk with your doctor or nurse about getting information on how to take care of your diabetes. Notes: __________________________________________________________________________________________ ___________________________________________________________________________________________ ___________________________________________________________________________________________ ___________________________________________________________________________________________ ___________________________________________________________________________________________ ___________________________________________________________________________________________ ___________________________________________________________________________________________ ___________________________________________________________________________________________ ___________________________________________________________________________________________ ___________________________________________________________________________________________ ___________________________________________________________________________________________ ___________________________________________________________________________________________ ___________________________________________________________________________________________ 1 Why should I care about my diabetes? Over time, high levels of sugar can damage blood vessels, nerve endings and other organs in your body. Health problems that can occur are: ■ Heart attack ■ Stroke ■ Eye problems that can lead to trouble seeing or going blind ■ Pain, tingling or numbness in your hands and feet ■ Kidney problems ■ Teeth and gum problems ■ Skin disorders ■ Sexual disorders ■ Stomach problems Keeping your blood sugar numbers in your target range can help you stay healthy. What is a blood sugar goal? ■ A blood sugar goal is a range of blood glucose values that you want to maintain on a daily basis. ■ Having a blood sugar goal helps you to manage your diabetes. ■ We encourage you to work with your doctor or health-care provider to help you decide a blood sugar goal that fits your needs. ■ Blood sugar goals for most people with diabetes: Goal Target Ranges Time Target Ranges Before Meals 80 –130 After Meals (1–2 hours) Less than 180 2 Blood Sugar Testing How do I know what my blood sugar is? The following are two ways to measure your blood sugar: 1. Testing your blood sugar with a glucose meter. 2. A1C (pronounced A-one-C) blood test. Why should I check my blood sugar? Checking your blood sugar helps you to see how food, physical activity, stress and medicine affect your blood sugar. ■ Keep a logbook of your blood sugar numbers and your A1C test. ■ Bring your logbook or glucose meter to each visit with your doctor. How often do I check my blood sugar? Ask your doctor when and how often you need to check your blood sugar. What equipment do I need to test my blood sugar? ■ Blood glucose meter ■ Blood glucose test strips. Blood glucose test strips are specific to the meter you will be using and are placed into the meter. ■ Lancets. A lancet is a needle device used to get a small amount of blood from your finger. ■ A sharps disposal container to throw away your needles and lancets. Your blood glucose meter will come with instructions on how to set up your meter. Please call the toll-free number on your meter if you are having problems with the meter. 3 What is the A1C test? ■ The A1C test is a blood test done in a lab that measures your average blood sugar levels over the past 2 to 3 months. Why should I have an A1C test? ■ The A1C test will tell you if your blood sugar levels have been close to normal, too high or too low. ■ The higher the amount of sugar in your blood, the higher your A1C result will be. How often do I need an A1C test? ■ A1C tests are usually done every 3 to 6 months. ■ Please ask your doctor each office visit if you have not had one in the past few months. What should my A1C goal be? ■ Discuss with your doctor what A1C goal is right for you. ■ An A1C goal of less than 7 percent is usually recommended for people living with diabetes. If your A1C is not at your goal, ask your doctor about helping you change your treatment plan. 13 326 12 298 11 269 10 240 A1C = Your average blood sugar 9 212 8 183 7 154 Over the past My A1C is 6 126 2-3 months. Estimated 5 100 What’s your Number? ______________ Average A1C % 4 65 Sugar 4 Diabetes Medicines: Insulin Insulin ■ Insulin lowers the blood sugar by moving sugar from the blood into the cells of the body. ■ Insulin is taken only by injection. ■ People living with Type 1 diabetes do not make insulin. Insulin is always needed. ■ Some people living with Type 2 diabetes may need insulin. Ask your doctor: ■ When to take your medicines ■ How much to take ■ How often to take them ■ What side effects they may cause 5 Types of insulin There are many different types of insulin. Rapid-acting insulin ■ Insulin glulisine (Apidra) ■ Insulin lispro (Humalog) ■ Insulin aspart (NovoLog) After injecting this type of insulin into the body, it will: ■ Begin to have an effect on blood sugar in about 15 minutes. ■ Peak, or have its strongest effect on blood sugar in about 1 hour. ■ Affect blood sugar for about 2 to 4 hours. Regular or short-acting insulin ■ Humulin R ■ Novolin R After injecting this type of insulin into the body, it will: ■ Begin to have an effect on blood sugar within 30 minutes. ■ Peak, or have its strongest effect on blood sugar in 2 to 3 hours. ■ Affect blood sugar for about 3 to 6 hours. Rapid and short-acting insulin should look clear to you and have no particles in the bottle. Rapid acting insulin that is cloudy, has a different color or has particles in the bottle should not be used. 6 Intermediate-acting insulin ■ NPH (Humulin N, Novolin N) After injecting this type of insulin in the body, it will: ■ Begin to have an effect on blood sugar in 2 to 4 hours. ■ Peak, or have its strongest effect on blood sugar, in about 4 to 12 hours. ■ Affect blood sugar for about 12 to 18 hours. Intermediate-acting insulin should look cloudy to you and have no particles in the bottle. Long-acting insulin ■ Insulin glargine (Lantus) ■ Insulin detemir (Levemir) After injecting this type of insulin into the body, it will: ■ Begin to have an effect on blood sugar levels in about 1 to 2 hours. ■ Have no peak time. ■ Affect blood sugar levels evenly over about 24 hours. Long-acting insulin should look clear to you and have no particles in the bottle. 7 How do I store my insulin? The way insulin is stored can affect how well the insulin will work on your blood sugar. ■ Insulin can be stored in the refrigerator. ■ Allow insulin that has been stored in the refrigerator to warm to room temperature for at least 15 minutes before using it. ■ Do not use insulin that has been stored in a freezer or insulin that was frozen. ■ Insulin should not be stored in the sun, on a window sill or near a heater. Insulin that is at warmer temperatures will not work as well. ■ Always look for cracks in the insulin bottle. ■ Insulin bottles are labeled with an expiration date. ■ Unopened bottles of insulin are good for up to the date written on the bottle. ■ Once the cap is removed from an insulin bottle, it is good to use for up to 28 days. Insulin that has particles, or that has expired is not recommended for use. Please contact your doctor or pharmacy if you have any concerns. How do I take my insulin safely? ■ Check your blood sugar before you take insulin. ■ Use caution when drinking alcohol. ■ Do not skip meals. ■ Try to eat about the same time every day. ■ Always have a snack, hard candy or glucose tablets with you. 8 Where can I inject my insulin? Insulin is injected into the layer of fat, just below the skin.
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